海角社区 Fri, 14 Aug 2026 21:19:08 +0000 en-US hourly 1 https://wordpress.org/?v=7.0.4 /wp-content/uploads/2021/03/cropped-cropped-CFHP_APP_ICON-32x32.png 海角社区 32 32 Fall Allergy Survival Guide /blog/fall-allergy-survival-guide/ Fri, 14 Aug 2026 21:19:01 +0000 /?p=315925

Clinical Contributor to this blog:

Jessica Yao, M.D.Chief Medical Officer

Fall is ALMOST here, and for many people in Texas, that means one thing: it鈥檚 sneezin鈥 season. Allergens like ragweed, mold, mountain cedar, oak, elm, and grass pollen are some of the biggest triggers in our area. In fact, the Asthma and Allergy Foundation of America rates San Antonio as the 4th most challenging city in the U.S. for fall allergy sufferers.

If you are constantly sneezing, rubbing your eyes, or feeling run-down this fall allergy season, you鈥檙e not alone. The good news is that there are simple steps you can take to feel better.

Recognizing the Symptoms

A lot of people mistake allergies for a cold, but unlike a cold, allergy symptoms often last for weeks at a time. Common allergy signs include sneezing, a runny or stuffy nose, itchy or watery eyes, and even fatigue. You may have heard the term 鈥渃edar fever,鈥 caused by mountain cedar. “Cedar fever” symptoms can be severe, but they do not actually include a fever. See our guide on COVID-19 vs. Flu vs. Allergies for more guidance on how to tell the difference and when to see a doctor.

Allergy Relief

San Antonio鈥檚 dry, windy climate allows pollen and mold levels to stay high and spread easily. However, these daily habits can make a difference in your symptoms all year long:

  • and limit outdoor activity on high-pollen days.
  • If you need to be outdoors, try to avoid peak pollen times, typically early mornings and early evenings.
  • Wear a mask and sunglasses.
  • Keep windows closed.
  • Shower and change clothes after being outdoors.
  • Use a saline (salt water) spray to rinse sinuses and ease congestion.
  • Stay hydrated and get enough rest to help your body recover.
  • Use over-the-counter allergy medications, such as loratadine or cetirizine, if they are safe for you.

When to See a Doctor

If you experience symptoms for more than two weeks, and they don鈥檛 improve with over-the-counter medicines or begin interfering with your sleep or daily life, you should reach out to a health care provider. If you or your kids have asthma, any wheezing or difficulty breathing should ALWAYS be taken seriously! See or call a doctor as soon as possible if you or your kids have asthma and experience difficulty breathing.

How 海角社区 First Can Help

海角社区 First is proud to offer programs and services that make allergy and asthma care easier to manage for families across San Antonio and the surrounding regions. Whether you need guidance on scheduling an appointment or specialized asthma education, support is always within reach:

  • Contact Member Services if听you need help scheduling an appointment or finding an in-network specialist.
  • Call our for support from a registered nurse who can help you decide where to go to get care.
  • Join 海角社区 First’s if you or your child has asthma for resources, support, and rewards for completing healthy actions*.
  • Schedule to and from your child鈥檚 medical appointments*.

*Limitations and restrictions apply. Call 210-358-6055 or emailhealthyhelp@cfhp.comfor more information.

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TMHP IAMOnline Training Materials and Custom Reports Portal Transition Updates /provider-news/tmhp-iamonline-training-materials-and-custom-reports-portal-transition-updates/ Fri, 07 Aug 2026 19:16:29 +0000 /?p=322040 海角社区 First is sharing important information from the Texas Medicaid & Healthcare Partnership (TMHP) regarding updated TMHP IAMOnline training materials and changes to the planned transition of the Custom Reports portal. TMHP IAMOnline is the new entry point for accessing applications on the TMHP website. Texas Medicaid Providers use TMHP IAMOnline to manage services, access resources, and perform essential TMHP-related tasks. TMHP IAMOnline Training Materials Update TMHP has updated training materials for the Medicaid Client Portal (MCP) and My Account applications to include TMHP IAMOnline login instructions. The updated training materials are available through the TMHP Learning Management System (LMS). Users must have an LMS username and password to access training materials. New users can select create a new user account from the LMS homepage to establish access. Custom Reports Portal Transition Update TMHP has announced that the Custom Reports online portal application will not transition to TMHP IAMOnline as part of the August 3, 2026 Release 3 implementation. TMHP will communicate a future implementation date for the Custom Reports transition through a subsequent provider notice. Additional details are available in TMHP’s article, Custom Reports Online Portal Application Will Not Transition to TMHP IAMOnline on August 3, 2026, available on […]

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海角社区 First is sharing important information from the Texas Medicaid & Healthcare Partnership (TMHP) regarding updated TMHP training materials and changes to the planned transition of the Custom Reports portal.

TMHP is the new entry point for accessing applications on the TMHP website. Texas Medicaid Providers use TMHP IAMOnline to manage services, access resources, and perform essential TMHP-related tasks.

TMHP IAMOnline Training Materials Update

TMHP has updated training materials for the Medicaid Client Portal (MCP) and My Account applications to include TMHP IAMOnline login instructions.

The updated training materials are available through the .

Users must have an LMS username and password to access training materials. New users can select from the LMS homepage to establish access.

Custom Reports Portal Transition Update

TMHP has announced that the Custom Reports online portal application will not transition to TMHP IAMOnline as part of the August 3, 2026 Release 3 implementation.

TMHP will communicate a future implementation date for the Custom Reports transition through a subsequent provider notice.

Additional details are available in TMHP’s article, , available on the

Applications Still Transitioning on August 3, 2026

The following applications remain scheduled to transition to TMHP IAMOnline on August 3, 2026:

  • Medicaid Client Portal (MCP)
  • Document Uploads
  • Provider Message Dashboard
  • My Account

Need Help?

For questions regarding TMHP IAMOnline, contact the TMHP EDI Help Desk at 888-863-3638. For LMS access issues, contact TMHPTrainingSupport@tmhp.com

Action:

Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also

To access all Provider alerts:

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Data Security Incident /member-news/data-security-incident/ Fri, 07 Aug 2026 17:42:34 +0000 /?p=321996

海角社区, Inc. (“海角社区 First”) recently experienced a data security incident that affected the personal information, including protected health information, of a limited group of 海角社区 First members.

海角社区 First has mailed a copy of the 鈥渘otice of breach鈥 letter below to affected members. That letter notifies them that they were impacted by this incident, explains what 海角社区 First is doing in response, and describes how to enroll in the 12 months of complimentary credit monitoring services 海角社区 First is providing to affected members. For a very small subset of affected members, 海角社区 First was unable to identify a current mailing address or other contact information.

If you did not receive a notice letter from 海角社区 First, but are concerned that your information may have been affected by this incident, you can email 海角社区 First at privacy@cfhp.com or call us at 800-434-2347, Monday to Friday from 8:00 a.m. to 5:00 p.m. Central Time, to learn whether you were affected, ask questions, and get information on how to access 海角社区 First鈥檚 free credit monitoring services.

If you were affected by this incident, we encourage you to read the notice of data breach below:

June 29, 2026
Re: NOTICE OF DATA BREACH

Dear [Affected Member Name],

海角社区, Inc. (鈥満=巧缜 First,鈥 鈥渨e,鈥 鈥渙ur,鈥 鈥渦s鈥) is writing to inform you of a data security incident that involved some of your personal information, including protected health information.

We take the privacy and security of your personal information very seriously. Although we are not aware of any actual misuse of your information as a result of this incident, due to the sensitive nature of the compromised personal information, we are writing to inform you of the incident, to advise you of steps to further protect your personal information, and to offer you twelve (12) months of complimentary identity monitoring services.

What Happened? On April 30, 2026, we became aware of an April 29 incident where a 海角社区 First employee uploaded a file containing personal information of some 海角社区 First members to ChatGPT, an online large language model artificial intelligence service. 海角社区 First does not utilize ChatGPT, and the employee was only able to access ChatGPT by intentionally circumventing 海角社区 First firewall safeguards and violating 海角社区 First policy.

In response, we immediately launched an investigation, revoked the employee鈥檚 access to 海角社区 First systems, directed and verified that the employee had deleted all personal information from their ChatGPT account, and contacted OpenAI, LLC (the operator of ChatGPT) to demand deletion of any related data. 海角社区 First retrieved all personal information from the employee and promptly ended with its relationship with the employee. Importantly, and as stated above, we are not aware of any misuse of personal information, but the compromised information is sensitive in nature. Therefore, we encourage you to review the information provided herein, including the steps you can take to further protect your personal information.

What Information Was Involved? Based on our investigation, the following categories of information related to you may have been affected: name, address, date of birth, member identification number, and prescription drug information.

What We Are Doing. The privacy and security of your personal information is our priority. Upon discovering the incident, we took the immediate steps described above. In addition, we are working to implement authorized log-on time windows for our employees, and mandatory VPN connectivity to our systems at all times to prevent future firewall bypass. We have also revised relevant policies and procedures, retrained our workforce, and distributed additional reminders to all staff regarding the prohibition on the use of unauthorized artificial intelligence tools and the consequences of violating our policies. We will continue to implement additional safeguards in light of new technologies and best practices.

Finally, although we are not aware of any impacted information having been misused, we will be offering you complimentary identity monitoring services for twelve (12) months. A description of those services and instructions on how to enroll will be mailed to you separately. Please note that you will need to complete the enrollment process yourself, as we are not permitted to enroll you in these services on your behalf.

What You Can Do. You can follow the recommendations on the following pages to help protect your personal information. While we are not aware that anyone鈥檚 information has been misused as a result of this incident, as a precautionary measure to safeguard your information, we encourage you to activate the identity monitoring services that will be offered to you at no charge.

For More Information. Further information and resources regarding the protection of your personal information appear on the following pages. If you have questions or concerns about this, or if we can be of further assistance to you, please do not hesitate to email us at privacy@cfhp.com or call us at 800-434-2347 from 8:00 a.m. to 5:00 p.m. central time.

We take your trust in us very seriously and are committed to the privacy and security of your personal information. We sincerely apologize for the concern and inconvenience that this incident has caused.

听Sincerely,

Stephanie Morris
Executive Director, Compliance and Risk Management
海角社区, Inc.

Steps You Can Take to Protect Your Personal Information

Monitor Your Accounts

We encourage you to remain vigilant against incidents of identity theft and fraud at least over the next twelve to twenty-four months and promptly report any incidents of suspected identity theft to us. We also encourage you to promptly change any involved account passwords, and to review account statements, credit reports, and explanations of benefits forms for suspicious activity. Under U.S. law you are entitled to one free credit report annually from each of the three major credit reporting bureaus. To order your free credit report, visit or call, toll-free, 1-877-322-8228. You may request to have information relating to any fraudulent transactions deleted.

You may also contact the three major credit bureaus directly to request a free copy of your credit report. You may wish to stagger your requests so that you receive a free report by one of the three credit bureaus every four months.

You have the right to place a 鈥渟ecurity freeze鈥 on your credit report, which will prohibit a consumer reporting agency from releasing information in your credit report without your express authorization. The security freeze is designed to prevent credit, loans, and services from being approved in your name without your consent. However, you should be aware that using a security freeze to take control over who gets access to the personal and financial information in your credit report may delay, interfere with, or prohibit the timely approval of any subsequent request or application you make regarding a new loan, credit, mortgage, or any other account involving the extension of credit. Pursuant to federal law, you cannot be charged to place or lift a security freeze on your credit report. Should you wish to place a security freeze, please contact the major consumer reporting agencies listed below:

Equifax Security Freeze
P.O. Box 105788
Atlanta, GA 30348
1-800-685-1111

Experian Security Freeze
P.O. Box 9554
Allen, TX 75013
1-888-397-3742

TransUnion Credit Freeze
P.O. Box 2000
Chester, PA 19016
1-888-909-8872

To request a security freeze, you will need to provide the following information:

  1. Your full name (including middle initial as well as Jr., Sr., II, III, etc.);
  2. Social Security number;
  3. Date of birth;
  4. If you have moved in the past five years, provide the addresses where you lived over the prior five years;
  5. Proof of current address, such as a current utility bill or telephone bill;
  6. A legible photocopy of a government-issued identification card (state driver鈥檚 license or ID card, military identification, etc.); and
  7. If you are a victim of identity theft, include a copy of either the police report, investigative report, or complaint to a law enforcement agency concerning identity theft.

As an alternative to a security freeze, you have the right to place an initial or extended 鈥渇raud alert鈥 on your file at no cost. An initial fraud alert is a one-year alert that is placed on a consumer鈥檚 credit file. Upon seeing a fraud alert display on a consumer鈥檚 credit file, a business is required to take steps to verify the consumer鈥檚 identity before extending new credit. If you are a victim of identity theft, you are entitled to an extended fraud alert, which is a fraud alert lasting seven years. Should you wish to place a fraud alert, please contact any one of the agencies listed below:

Experian
P.O. Box 9554 Allen, TX 75013
1-888-397-3742

TransUnion
P.O. Box 2000 Chester, PA 19016
1-800-680-7289

Equifax
P.O. Box 105069 Atlanta, GA 30348
1-888-766-0008

If you believe you are the victim of identity theft, you should contact the proper law enforcement authorities, including local law enforcement, and consider contacting your state attorney general and/or the Federal Trade Commission (鈥淔TC鈥). You may obtain information from the FTC and the credit reporting agencies listed above about placing a fraud alert and/or credit freeze on your credit report. You may contact the FTC to obtain additional information about avoiding identity theft at the following:

Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue NW
Washington, DC 20580
(877) IDTHEFT (438-4338)

The Federal Trade Commission also encourages those who discover that their information has been misused to file a complaint with them. You can obtain further information on how to file such a complaint using the contact information listed above. You have the right to file a police report if you ever experience identity theft or fraud. Please note that to file a report with law enforcement for identity theft, you will likely need to provide some proof that you have been a victim. Instances of known or suspected identity theft should also be reported to law enforcement and your state Attorney General.

This notice has not been delayed by law enforcement.

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Important Notice: 2027 Maternity Care Coding Updates /provider-news/important-notice-2027-maternity-care-coding-updates/ Mon, 03 Aug 2026 17:40:30 +0000 /?p=321914 Effective January 1, 2027 The American Medical Association (AMA) has released significant revisions to the CPT庐 Maternity Care Services section that will become effective January 1, 2027. These changes affect how maternity care services are reported and include the introduction of new labor management codes and the deletion of several longstanding maternity package codes. 海角社区 First is currently reviewing these revisions and will provide additional guidance as more information becomes available. Providers should monitor future communications for detailed information regarding these changes and any related billing or reimbursement requirements. 海角社区 First will post additional updates and provider notices in the coming months. Please watch for future communications. Key Changes Beginning January 1, 2027: New Labor Management Codes CPT Code Description 59080 Initial day labor management – straightforward 59081 Initial day labor management – complex 59082 Subsequent day labor management – straightforward 59083 Subsequent day labor management – complex Delivery Codes CPT Code Description 59431 Vaginal delivery 59432 Vaginal birth after cesarean (VBAC) 59502 Primary cesarean delivery 59503 Repeat cesarean delivery What Providers Should Do Providers are encouraged to: Additional Information This notification is intended as an advance awareness communication. Providers should refer to the AMA CPT庐 2027 Professional Edition and […]

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Effective January 1, 2027

The American Medical Association (AMA) has released significant revisions to the CPT庐 Maternity Care Services section that will become effective January 1, 2027. These changes affect how maternity care services are reported and include the introduction of new labor management codes and the deletion of several longstanding maternity package codes.

海角社区 First is currently reviewing these revisions and will provide additional guidance as more information becomes available. Providers should monitor future communications for detailed information regarding these changes and any related billing or reimbursement requirements.

海角社区 First will post additional updates and provider notices in the coming months. Please watch for future communications.

Key Changes

Beginning January 1, 2027:

  • Antepartum care will be reported using appropriate Evaluation and Management (E/M) codes.
  • New labor management codes (59080-59083) will be used to report inpatient labor management services.
  • Delivery care will be reported separately using revised vaginal and cesarean delivery codes.
  • Postpartum care will be reported using appropriate E/M codes.
  • Numerous existing global maternity package codes will be deleted.

New Labor Management Codes

CPT Code Description
59080Initial day labor management – straightforward
59081Initial day labor management – complex
59082Subsequent day labor management – straightforward
59083Subsequent day labor management – complex

Delivery Codes

CPT CodeDescription
59431Vaginal delivery
59432Vaginal birth after cesarean (VBAC)
59502Primary cesarean delivery
59503Repeat cesarean delivery

What Providers Should Do

Providers are encouraged to:

  • Review the CPT庐 2027 maternity care revisions.
  • Assess coding and billing workflows for maternity services.
  • Educate coding, billing, and clinical staff regarding the new reporting requirements.
  • Monitor future communications regarding reimbursement policies and implementation guidance.

Additional Information

This notification is intended as an advance awareness communication. Providers should refer to the AMA CPT庐 2027 Professional Edition and applicable payer policies for complete coding and billing guidance. Additional implementation information will be communicated as it becomes available.

Action

Please share this information with appropriate staff members within your organization.

If you have questions regarding this notice, please contact Provider Relations by email at ProviderRelations@cfhp.com听or by phone at听210-358-6030. You can also听contact your Provider Relations Representative directly.

To access all Provider alerts:

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Healthy Texas Women (HTW) Pharmacy Benefit Update Effective July 1, 2026 /provider-news/healthy-texas-women-htw-pharmacy-benefit-update-effective-july-1-2026/ Thu, 23 Jul 2026 14:57:32 +0000 /?p=321430 海角社区 is sharing information regarding updates to the Healthy Texas Women (HTW) program pharmacy benefit that became effective July 1, 2026. HTW provides women’s health and family planning services to eligible women, while HTW Plus offers enhanced postpartum services for women who have been pregnant within the previous 12 months. HTW Plus services focus on conditions that contribute to maternal morbidity and mortality, including postpartum depression, cardiovascular conditions, and substance use disorders. Program Updates Effective July 1, 2026, the list of covered drugs available to HTW members expanded to include all Medicaid鈥慹ligible drugs within health care categories covered by the HTW program. In addition, the Texas Health and Human Services Commission (HHSC) has aligned HTW pharmacy coverage with Texas Medicaid by applying: These changes support HHSC’s transition of HTW from a state-funded program to a Medicaid-funded program and help promote consistency across Medicaid programs. Provider Considerations Providers are encouraged to review the updated PDL and applicable prior authorization requirements when prescribing medications for Healthy Texas Women members. Changes to formulary status may affect coverage and authorization requirements for certain drugs. Resources For questions regarding pharmacy benefits or prior authorization requirements, contact the Texas Medicaid Pharmacy and Technical […]

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海角社区 is sharing information regarding updates to the Healthy Texas Women (HTW) program pharmacy benefit that became effective July 1, 2026.

HTW provides women’s health and family planning services to eligible women, while HTW Plus offers enhanced postpartum services for women who have been pregnant within the previous 12 months. HTW Plus services focus on conditions that contribute to maternal morbidity and mortality, including postpartum depression, cardiovascular conditions, and substance use disorders.

Program Updates

Effective July 1, 2026, the list of covered drugs available to HTW members expanded to include all Medicaid鈥慹ligible drugs within health care categories covered by the HTW program.

In addition, the Texas Health and Human Services Commission (HHSC) has aligned HTW pharmacy coverage with Texas Medicaid by applying:

  • The Texas Medicaid Preferred Drug List (PDL)
  • Applicable clinical prior authorization requirements
  • Existing Medicaid formulary requirements for covered drugs

These changes support HHSC’s transition of HTW from a state-funded program to a Medicaid-funded program and help promote consistency across Medicaid programs.

Provider Considerations

Providers are encouraged to review the updated PDL and applicable prior authorization requirements when prescribing medications for Healthy Texas Women members. Changes to formulary status may affect coverage and authorization requirements for certain drugs.

Resources

  • Healthy Texas Women Program
  • TMHP Healthy Texas Women Information
  • Texas Medicaid Preferred Drug List (PDL)
  • PDL Criteria Guide

For questions regarding pharmacy benefits or prior authorization requirements, contact the Texas Medicaid Pharmacy and Technical Call Center at 800-435-4165, Monday through Friday, 7 a.m. to 7 p.m. Central Time.

Action:

Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.

To access all Provider alerts:

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Boost Your Brain Power with These Simple Daily Activities /blog/boost-your-brain-power-with-these-simple-daily-activities/ Tue, 21 Jul 2026 21:59:25 +0000 /?p=314571

Put on your thinking caps and celebrate World Brain Day, July 22!

World Brain Day on July 22 honors advances in brain science and promotes brain health. Our brain is an incredible organ that can change and reorganize itself throughout our lives. There are many ways to maintain sharp and healthy brains at every age!

Learn something new!

听Almost any new skill or hobby that you learn, especially if it makes you interact with other people, can boost memory, brain flexibility, and social abilities. Try learning a craft like pottery, knitting, or cooking a new recipe. Learning a language activates multiple brain areas and helps protect against dementia.

Hands-on Activities

The mind-body connection is powerful! By physically moving puzzle pieces or writing something down on paper, you are stimulating the part of your brain linked to focus and memory. Keep reading for a few hands-on activities that can boost brain health.

Keep on Moving

As we age, we can experience more aches and pains, stiff joints, and more. When we experience pain, we often move around and exercise less, even though we know movement is good for our brains and bodies. However, almost any exercise can be changed to suit a different fitness, balance, or strength level. Look up modified exercises, such as those shown by or .

You can also try an exercise like , which is low intensity, low impact, can help improve balance, flexibility, and mobility, and reduce stress or anxiety. Simply walking when possible is also great for your brain health. According to a study in the Harvard Gazette, walking 3,000 to 5,000 steps can help delay the onset of dementia and Alzheimer’s.

BRAIN GAMES

Brain games challenge focus, encourage using memory, and activate reasoning鈥攍ike how different exercises work different muscles. Start with games you enjoy, then try harder or new ones for better results.

Crossword puzzles: Crossword puzzles help improve vocabulary and long-term memory. Try the crossword puzzle in a newspaper or a crossword puzzle book. Writing down your answers is better, but you can also find free crossword puzzles online.

Sudoku: Number puzzles like Sodoku can sharpen logic and attention.

Jigsaw puzzles: Puzzles can help with focus and visual-spatial reasoning while inspiring creativity.

Cards/Dominoes/Matching: Card and matching games train memory, concentration, and problem-solving, plus they鈥檙e social and fun.

Board Games: Board games can activate mental superpowers. Chess, Checkers, Clue, Jenga, and Scrabble stimulate problem-solving, logic, memory, and social interaction. Mahjong is another board game played with tiles that is growing in popularity and provides a great brain workout!

Fun Fact

You can borrow most of these brain boosters for free with a library card at your local library!

 

Prefer Digital?

There are several apps for playing brain games, too. If you are already spending a lot of time in front of a screen, try switching out a “brain-rot” activity (like scrolling on social media) with a game instead. Here are some apps that offer brain training activities for free. (Some may offer more features with a paid subscription):

      • :This one helps you meet specific brain training goals. After setting up a profile, you can play three games for free every day.
      • : Greater Good offers many free online games, from crossword puzzles to solitaire, trivia, matching, and more. Bonus: Greater Good raises money through ad revenue and donates money to charities fighting hunger and supporting veterans, animal rescues, cancer research, and others. They have raised and donated more than $80 million to good causes so far.
      • : The New York Times offers daily games that you can play through a phone app or web browser. When the user sets up a profile, they can play word, number, and matching games every day, once a day, for free. This includes the popular Wordle game.
      • : AARP online has a lot of free online games. Start with a game in your comfort zone and then add other games that are new or challenging.

听Of course, don鈥檛 forget the basics: good sleep, exercise, healthy meals, socializing, and regular checkups with your primary care provider are vital for a healthy brain AND body.

Mental health is also important! Check out our blog for several mental health tips. Keep challenging yourself, keep learning, and happy brain training!

Sources:

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Brain-Builders for Kids and Teens /blog/brain-builders-for-kids-and-teens/ Tue, 21 Jul 2026 21:45:55 +0000 /?p=321136

Build on children’s interests and natural curiosity to make learning fun!

Header image of smiling teenage girl playing board game with two friends at home or in school dorm and removing wooden block from tower

Let kids and teens get involved in activities they already love, and as a bonus, they’ll learn basic life skills. Games and activities gently train your kids’ brains for school and life! July 22 is World Brain Day, and it’s never too early to start strengthening the mind.

Stimulate their brains (and yours, too) with these games:

Identification: Games like “I Spy,” where they describe something you and they can both see, or “I talk, you draw,” where one person draws what the other describes, build verbal and observational skills.

Sorting: Putting similar items into groups based on color, shape, size, or another quality teaches basic skills they will use in school and for the rest of their lives.

Building: Whether small, like Lego sets or jigsaw puzzles, or big, like pillow forts, building activities let them flex their problem-solving, creativity, and agility.

“My little helper”: Kids who follow their grown-ups around the house often enjoy helping out in the kitchen or elsewhere. Give them tasks that are safe and doable for their age (measuring or mixing ingredients, sorting laundry, or watering plants, for example), and let them fly. This teaches valuable real-life skills and can give them a sense of pride.

Board games: Board games like Clue usually come with a recommended age range and often teach useful skills (problem-solving, math, memory, identification, etc.).

Scavenger hunts/obstacle courses/role-playing: These activities engage players by providing clues or quests to prompt educated guesses, or they pose a problem to solve. Anyone can create a scavenger hunt or obstacle course for or using items in or around the home or outdoors.

Word games: Crossword puzzles, fill-in-the-blank activities like Mad Libs, or word association games (e.g., “Name something that starts with a G”) support vocabulary development and may inspire a lifelong love of language.

Physical activities: Exercise and movement are also good for the brain! Think of balance, agility, and other motor skills that depend on the brain-body connection.

Games and activities are a key factor in brain and social development. Take time to do something “just for fun” every day, and watch your children grow in their skills and confidence.

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IMPORTANT REMINDER: Upcoming Policy Changes Related to Improvements in Claims Processing /provider-news/important-reminder-upcoming-policy-changes-related-to-improvements-in-claims-processing/ Mon, 20 Jul 2026 19:36:58 +0000 /?p=319013

Effective August 3, 海角社区 will enhance the existing claims processing program to improve the overall accuracy of claim processing in partnership with Cotiviti. We want to share this information in advance, so you are prepared for the upcoming changes.

To support accurate claims submission and reduce denials, Providers are encouraged to review the following notices, which outline specific coding and coverage requirements impacted by clinical editing:

鈥 Clarifies the appropriate use of laboratory services and documentation requirements.

Medical Nutrition Therapy (MNT) Services: Coding and Billing Guidance 鈥 Details covered diagnoses, frequency limitations, and billing rules for MNT services.

Lung Cancer Screening with Low-Dose Computed Tomography (LDCT): Coverage and Billing Guidance 鈥 Outlines diagnosis, age, and frequency requirements for LDCT screening services.

鈥 Explains billing, coding, and documentation requirements for devices that meet the FDA definition of an implant.

Wheeled Mobility Systems: QRP Seating Assessment and Billing Guidance 鈥 Provides billing requirements for Qualified Rehabilitation Provider (QRP) participation in seating assessments and final fittings for wheeled mobility systems.

Modifier 25: Correct Use and Coding Guidance for Preventive and Acute Care Services 鈥 Clarifies appropriate billing and documentation requirements when reporting a significant, separately identifiable E/M service on the same date as a preventive visit.

Modifier 26: Correct Use and Coding Guidance for Diagnostic Services (Professional Component) 鈥 Explains proper reporting of the professional component of diagnostic services and appropriate use of Modifier 26.

These notices and other coding guidance resources are also available on the听.

The goals of this endeavor are to implement, to the extent possible, claim payment policies that are broad in scope, simple to understand and that come from regulatory guidance.听 We believe that this will enable you and your billing staff to more readily understand our payment of claims given the widespread use of these policies.

We focused our payment policies on nationally accepted means of claims payment, which include:

  • American Medical Association (AMA) CPT庐 coding guidelines
  • National and regional Medicare policies
  • National specialty academy guidelines
  • State Medicaid guidelines, as applicable

海角社区 First鈥檚 payment policies focus on areas including, but not limited to, the following:

  • AMA CPT庐 procedure code definitions and guidelines
  • National Correct Coding Initiative (NCCI)
  • Modifier usage
  • ICD鈥10鈥慍M diagnosis code guidelines
  • Global Surgery periods
  • Evaluation and Management (E/M) guidelines
  • Add鈥憃n code usage
  • Professional, technical, and global billing rules
  • 顿颈补驳苍辞蝉颈蝉鈥憈辞鈥憄谤辞肠别诲耻谤别
  • Place of service requirements
  • Age鈥慳ppropriate services
  • CMS National and Local Coverage Determinations (NCDs and LCDs)
  • Revenue code validation

After the implementation, you may receive claims denials or payment changes based on these enhanced claim editing concepts on your Explanation of Benefits or electronic remittances. For additional information on the specifics of your claim submission payment decisions, or to file a grievance or appeal, please contact Provider Services at听210-358-6030听or use our online directory to听contact your Provider Relations representative directly.

Action:

Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.

To access all Provider alerts:

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Texas Medicaid Preferred Drug List (PDL) Update Effective July 24, 2026 /provider-news/texas-medicaid-preferred-drug-list-pdl-update-effective-july-24-2026/ Fri, 17 Jul 2026 19:51:47 +0000 /?p=321081 海角社区 is sharing information regarding the Texas Medicaid Preferred Drug List (PDL) update scheduled for July 24, 2026. The update reflects recommendations from the January and April 2026 Texas Drug Utilization Review (DUR) Board meetings. The updated PDL and PDL Criteria Guide will be available on July 24, 2026. Preferred Drug List (PDL) Overview The Texas Medicaid formulary categorizes drugs as preferred, non-preferred, or neither preferred nor non-preferred. In general: Changes to a drug’s preferred status may affect prescribing decisions, prior authorization requirements, and member access to medications. Notable July 2026 Changes New PDL Class Renamed PDL Classes Prescriber Considerations Providers are encouraged to review the updated PDL and applicable prior authorization criteria before prescribing medications that may be affected by these changes. Providers should also review formulary status and authorization requirements when initiating therapy or renewing existing prescriptions. Resources Please refer to the original TMHP Preferred Drug List Update notice for more information. Action: Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly. To access all Provider alerts:

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海角社区 is sharing information regarding the Texas Medicaid Preferred Drug List (PDL) update scheduled for July 24, 2026. The update reflects recommendations from the January and April 2026 Texas Drug Utilization Review (DUR) Board meetings.

The updated PDL and PDL Criteria Guide will be available on July 24, 2026.

Preferred Drug List (PDL) Overview

The Texas Medicaid formulary categorizes drugs as preferred, non-preferred, or neither preferred nor non-preferred.

In general:

  • Preferred drugs are available without PDL prior authorization.
  • Non-preferred drugs require prior authorization.
  • Some preferred and non-preferred drugs may also be subject to clinical prior authorization requirements.

Changes to a drug’s preferred status may affect prescribing decisions, prior authorization requirements, and member access to medications.

Notable July 2026 Changes

New PDL Class

  • Duchenne Muscular Dystrophy Agents

Renamed PDL Classes

  • Calcium Channel Blockers (Oral) 鈫 Calcium Channel Blockers
  • PAH Agents (Oral, Inhalation) 鈫 PAH Agents
  • Skeletal Muscle Relaxants 鈫 Skeletal Muscle Relaxants and Related Agents
  • Proton Pump Inhibitors 鈫 Stomach Acid Reducers and Related

Prescriber Considerations

Providers are encouraged to review the updated PDL and applicable prior authorization criteria before prescribing medications that may be affected by these changes.

Providers should also review formulary status and authorization requirements when initiating therapy or renewing existing prescriptions.

Resources

  • Texas Medicaid Preferred Drug List (PDL):
  • PDL Criteria Guide (PDF):
  • Texas Drug Utilization Review (DUR) Board Documents:
  • Quarterly PDL Updates:
  • Texas Medicaid Vendor Drug Program:

Please refer to the original notice for more information.

Action:

Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.

To access all Provider alerts:

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New Login Process for All Texas Medicaid Providers Through TMHP IAMOnline and Provider MFA Registration 鈥 Releases 3 and 4 /provider-news/new-login-process-for-all-texas-medicaid-providers-through-tmhp-iamonline-and-provider-mfa-registration-releases-3-and-4/ Fri, 17 Jul 2026 17:50:15 +0000 /?p=319081 海角社区 is sharing important information from the Texas Medicaid & Healthcare Partnership (TMHP) regarding the continued transition of Provider applications to TMHP IAMOnline. Effective August 3, 2026, TMHP will add additional online portal applications to TMHP IAMOnline. TMHP IAMOnline serves as the secure entry point for accessing TMHP applications and provides single sign-on and account management functionality. TMHP IAMOnline Account Activation Providers should have received TMHP IAMOnline activation emails on June 8 or June 15, 2026. TMHP also issued an additional IAMOnline activation email on July 28, 2026. Providers should check their email inbox for the activation email and follow the instructions provided to complete account activation. To begin the activation process, select the Activate Account button included in the email. To activate an account, Providers must: Providers have seven days from receipt of the activation email to complete the activation process. Providers who did not act on either the June 8 or June 15 activation email must contact the TMHP Electronic Data Interchange (EDI) Help Desk and request that the activation email be resent. Providers who have not received a TMHP IAMOnline activation email should: Providers who complete these troubleshooting steps and still have not received […]

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海角社区 is sharing important information from the Texas Medicaid & Healthcare Partnership (TMHP) regarding the continued transition of Provider applications to

Effective August 3, 2026, TMHP will add additional online portal applications to TMHP IAMOnline. TMHP IAMOnline serves as the secure entry point for accessing TMHP applications and provides single sign-on and account management functionality.

TMHP IAMOnline Account Activation

Providers should have received TMHP IAMOnline activation emails on June 8 or June 15, 2026.

TMHP also issued an additional IAMOnline activation email on July 28, 2026. Providers should check their email inbox for the activation email and follow the instructions provided to complete account activation.

To begin the activation process, select the Activate Account button included in the email.

To activate an account, Providers must:

  1. Follow the instructions included in the activation email.
  2. Log in to TMHP IAMOnline.
  3. Set a password.
  4. Register multi-factor authentication (MFA).

Providers have seven days from receipt of the activation email to complete the activation process.

Providers who did not act on either the June 8 or June 15 activation email must contact the TMHP Electronic Data Interchange (EDI) Help Desk and request that the activation email be resent.

Providers who have not received a TMHP IAMOnline activation email should:

Providers who complete these troubleshooting steps and still have not received an activation email should contact the TMHP EDI Help Desk at 888-863-3638 for assistance.

After activation is complete, Providers can access transitioned applications through the TMHP IAMOnline My Apps Dashboard.

Provider MFA Registration

TMHP IAMOnline offers single sign-on and password self-service capabilities. When logging in to TMHP IAMOnline, Texas Medicaid Providers are required to use MFA.

Providers will:

  • Register their MFA when they activate their TMHP IAMOnline account.
  • Be automatically enrolled in email-based MFA.
  • Have the option to add Okta Verify or Google Authenticator as additional MFA methods.

To access Okta Verify or Google Authenticator, Providers will download the app from听听or听听to their primary mobile device. Providers can set up the account with either a QR code or with a sign-in uniform resource locator (URL).

Portal Applications Transitioning in Release 3

Effective August 3, 2026, the following applications will transition to TMHP IAMOnline:

  • Custom Reports
  • Medicaid Client Portal (MCP)
  • Document Uploads
  • Provider Message Dashboard
  • My Account

Portal Applications Transitioning in Release 4

Effective August 24, 2026, the following applications will transition to TMHP IAMOnline:

  • Long-term Care Online Portal (LTCOP)
  • Long-term Care (LTC) Dashboard
  • Electronic Visit Verification (EVV) Portal
  • Care Forms

TMHP will continue to announce future transition dates as additional applications migrate to TMHP IAMOnline.

Important Reminder

Providers who already have Texas Health and Human Services Commission (HHSC) IAMOnline access for the State of Texas Electronic Provider System (STEPS) must still activate their TMHP IAMOnline account to access TMHP applications.

Accessing Applications Not Yet Transitioned

The TMHP IAMOnline login process applies only to applications that have already transitioned to the platform.

For applications that have not yet transitioned, Providers should continue using:

  • Their current My Account username, and
  • The new password created during TMHP IAMOnline account activation.

NEED HELP?

For assistance, contact the TMHP EDI Help Desk at 888-863-3638.

Additional details can be found in TMHP’s IAMOnline implementation articles and on the

Action:

Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also

To access all Provider alerts:

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